JP2009508615A5 - - Google Patents
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- JP2009508615A5 JP2009508615A5 JP2008531811A JP2008531811A JP2009508615A5 JP 2009508615 A5 JP2009508615 A5 JP 2009508615A5 JP 2008531811 A JP2008531811 A JP 2008531811A JP 2008531811 A JP2008531811 A JP 2008531811A JP 2009508615 A5 JP2009508615 A5 JP 2009508615A5
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- 210000000988 Bone and Bones Anatomy 0.000 description 32
- 238000004873 anchoring Methods 0.000 description 30
- 230000000295 complement Effects 0.000 description 9
- 230000000875 corresponding Effects 0.000 description 9
- 238000003780 insertion Methods 0.000 description 4
- 230000001154 acute Effects 0.000 description 2
- 210000003484 anatomy Anatomy 0.000 description 2
- 230000001808 coupling Effects 0.000 description 2
- 238000010168 coupling process Methods 0.000 description 2
- 238000005859 coupling reaction Methods 0.000 description 2
- 230000000452 restraining Effects 0.000 description 2
- 230000001419 dependent Effects 0.000 description 1
- 239000007943 implant Substances 0.000 description 1
- 230000002269 spontaneous Effects 0.000 description 1
Description
本発明は脊柱の脊椎間の結合を確実にする線維軟骨円盤（ｆｉｂｒｏｃａｒｔｉｌａｇｉｎｏｕｓ ｄｉｓｃｓ）の代用とされるように意図された椎間板プロテーゼに関する。 The present invention relates to an intervertebral disc prosthesis intended to be substituted for fibrocartilaginous discs that ensure the connection between the vertebrae of the spinal column.
異なる種類の椎間板プロテーゼが、従来技術において公知である。例えばＰＣＴ国際公開ＷＯ０２０８９７０１及びＰＣＴ国際公開ＷＯ２００４／０４１１２９に公開されたような多数のプロテーゼは、中心コア部の周りに関節結合されたケージを形成する下方プレート及び上方プレートからなる。例えば、米国特許第５６７６７０１号及びＰＣＴ国際公開ＷＯ０３／０５９２１２Ａ１に開示されたような他のプロテーゼは、関節結合面により互いに関節結合した下方プレートと上方プレートとだけを含んでいる。これらの関節結合したプロテーゼは、プレートが互いに対して傾斜すること及び／又は回転することを可能にすることにより、かかるプロテーゼを具備する患者に動作の自由を提供するという利点を有する。プレート同士の間において可動である中心コア部を含むプロテーゼは、プロテーゼに付与される荷重を吸収する理想的な位置への中心コア部の自発的な位置決めを可能にするという更なる利点を有する。従来技術において公知であるこれらのプロテーゼにおいては、プレートの前方、後方、及び側方エッジは、別のプレートの対応するエッジと同一の鉛直軸に配置される。かかるプロテーゼのこの形状は、同一のサイズであるプレートのためであり、関節結合の各軸は、患者の動作を容易にし、起こり得る位置欠陥を修正することが可能なように（同軸に）結合される。しかしながら、これらのプロテーゼは、脊柱の形態に完全に適合していないという不利益を有する。さらに、２つの隣接する脊椎の後方エッジは、たいてい互いにわずかにオフセットされている。よって、従来技術において公知のプロテーゼは、正確に移植することが困難である。さらに、椎骨の天然のオフセット及び椎骨におけるプレートの固着のために、荷重がプロテーゼの異なる部分の動作の自由度を制限するので、プロテーゼの異なる部分は望ましくない位置における荷重の下にある。この不都合は、プレート同士の間に可動コア部を使用することにより低減されるが、コア部の可能な動作は制限され、プロテーゼに付与される荷重を吸収するようにコア部を位置決めする能力は低減される。 Different types of intervertebral disc prostheses are known in the prior art. A number of prostheses, such as those disclosed in PCT International Publication No. WO02080901 and PCT International Publication No. WO2004 / 041129, consist of a lower plate and an upper plate that form an articulated cage around a central core. For example, other prostheses, such as those disclosed in US Pat. No. 5,676,701 and PCT International Publication No. WO 03 / 059212A1, include only a lower plate and an upper plate that are articulated together by articulating surfaces. These articulated prostheses have the advantage of providing freedom of movement for patients with such prostheses by allowing the plates to tilt and / or rotate relative to each other. A prosthesis that includes a central core that is movable between the plates has the further advantage of allowing spontaneous positioning of the central core in an ideal position that absorbs the load applied to the prosthesis. In these prostheses known in the prior art, the front, rear and side edges of a plate are arranged on the same vertical axis as the corresponding edge of another plate. This shape of such a prosthesis is for plates of the same size, and each axis of articulation is coupled (coaxially) to facilitate patient movement and to correct possible positional defects Is done. However, these prostheses have the disadvantage that they are not perfectly adapted to the shape of the spinal column. In addition, the posterior edges of two adjacent vertebrae are often slightly offset from each other. Thus, prostheses known in the prior art are difficult to implant accurately. In addition, because of the natural offset of the vertebra and the fixation of the plate in the vertebra, the different parts of the prosthesis are under load in undesired locations because the load limits the freedom of movement of the different parts of the prosthesis. This inconvenience is reduced by using a movable core between the plates, but the possible movement of the core is limited and the ability to position the core to absorb the load applied to the prosthesis Reduced.
これは、特許出願ＥＰ１２５０８９８Ａ１のような従来技術において公知であり、椎間板プロテーゼは、中心コア部の周りに関節結合した２つのプレートを含んでいる。プレートの一方の寸法は、少なくとも１つのかかるプレートのエッジにおいて、別のプレートの寸法よりも大きい。プレートの寸法のこの差は、プレートのエッジのオフセットを生ずるけれども、プレートの関節結合の軸のオフセットを生ずるという不都合を有する。さらに、この種類のプロテーゼは、かかるプロテーゼのプレートの１つが椎骨プレートと比較して大きいか、反対に、別のプレートが椎骨プレートより小さく、椎骨プレートの周囲に寄りかからず、わずかな剛性部分に寄りかかるので、プロテーゼは椎骨プレートを損傷するリスクを有するという不都合を有する。 This is known in the prior art, such as patent application EP1250898A1, where the intervertebral disc prosthesis includes two plates articulated around a central core. One dimension of the plate is greater than the dimension of another plate at the edge of at least one such plate. This difference in plate dimensions has the disadvantage of causing an offset of the plate articulation axis, although it results in an offset of the edge of the plate. In addition, this type of prosthesis has one such prosthesis plate larger than the vertebra plate, or conversely, another plate is smaller than the vertebra plate and does not lean around the vertebra plate, with a slight stiffness The prosthesis has the disadvantage of risking damage to the vertebral plate.
これに関連して、脊柱の形状に効率的にフィットし、関節結合の表面を提供する目標を十分に達成することが可能であるプロテーゼを提案することは有益である。 In this regard, it would be beneficial to propose a prosthesis that can efficiently fit the shape of the spinal column and fully achieve the goal of providing an articulating surface.
本発明の目的は、２つのプレートを少なくとも含む椎間板プロテーゼを提案することにより、従来技術の不都合の幾つかを解消することである。かかる２つのプレートは、他方のプレートの同一のエッジに対してオフセットされた少なくとも１つのエッジを具備している。 The object of the present invention is to overcome some of the disadvantages of the prior art by proposing an intervertebral disc prosthesis comprising at least two plates. Such two plates have at least one edge that is offset relative to the same edge of the other plate.
この目標は、脊柱の椎骨同士の間に移植する椎間板プロテーゼにより達成される。かかる椎間板プロテーゼは、少なくとも２つのプレート、すなわち第１プレート及び第２プレートを含み、かかる少なくとも２つのプレートは、すくなくとも１つのプレートの少なくとも１つの曲面部、すなわち関節結合部により互いに関節結合されており、プレートの平面に実質的に垂直な軸及び実質的にプレートの平面における軸の周りの回転を介して、互いに対して枢動すること及び／又は傾斜することが可能である。前記湾曲した関節結合はプロテーゼの関節結合の中心部に鉛直方向に整列された頂部を有する。各プレートは、エッジ及びプロテーゼが移植される椎骨の１つの椎骨プレートと接触する接触面として公知である表面を含んでいる。各プレートのためのこの接触面は、プレートの周囲に配置された少なくとも２つの直径方向に対向する点から等距離の幾何学的中心部を含んでおり、以下のように特徴付けられる。 This goal is achieved by an intervertebral disc prosthesis that is implanted between vertebrae of the spinal column. Such an intervertebral disc prosthesis includes at least two plates, i.e., a first plate and a second plate, wherein the at least two plates are articulated to each other by at least one curved surface, i.e., articulation, of at least one plate. It is possible to pivot and / or tilt relative to each other via rotation about an axis substantially perpendicular to the plane of the plate and an axis substantially in the plane of the plate. The curved articulation has a top aligned vertically in the center of the prosthesis articulation. Each plate edge and prosthesis includes a surface is known as the contact surface you contact with one vertebra plates of the vertebrae to be implanted. This contact surface for each plate includes a geometric center equidistant from at least two diametrically opposed points located around the plate and is characterized as follows.
プロテーゼの関節結合の中心部はプレートの幾何学的中心部の１つと鉛直方向に整列され、
プレートの幾何学的中心部同士は、鉛直方向に整列されず、脊柱の鉛直軸に垂直な少なくとも一方向へオフセットされ、
２つのプレートの接触面は実質的に同一の寸法を有し、プレートのエッジは、脊柱の鉛直軸に垂直な少なくとも一方向へオフセットされている。
The prosthetic articulation center is vertically aligned with one of the geometric centers of the plate,
The geometric centers of the plates are not vertically aligned but are offset in at least one direction perpendicular to the vertical axis of the spinal column,
The contact surfaces of the two plates have substantially the same dimensions, and the plate edges are offset in at least one direction perpendicular to the vertical axis of the spinal column.
別の特徴によれば、第２プレートは関節結合の曲面部を含み、かかる曲面部の少なくとも一部が、相補的である第１プレートの関節結合の曲面部と協働し、互いに対するプレートの枢動及び／又は傾斜により関節結合を可能にし、第２プレートの関節結合の曲面部の頂部と鉛直方向に整列された関節結合の中心部は、第２プレートに対する第１プレートの曲面部の中心部の中央位置に対応する。 According to another feature, the second plate includes an articulated curved surface portion, at least a portion of such a curved surface portion cooperating with the complementary articulating curved surface portion of the first plate, and The articulation center by pivoting and / or tilting and allowing the articulation center to be aligned vertically with the top of the articulation surface of the second plate is the center of the articulation surface of the first plate relative to the second plate. Corresponds to the center position of the part.
別の特徴によれば、第１プレートの曲面部は凹面であり且つ第２プレートの関節結合の曲面部は凸面である。 According to another feature, the curved surface of the first plate is concave and the curved surface of the articulation of the second plate is convex.
別の特徴によれば、第１プレートの曲面部は凸面であり且つ第２プレートの関節結合の曲面部は凹面である。 According to another feature, the curved surface of the first plate is convex and the curved surface of the articulation of the second plate is concave.
別の特徴によれば、椎間板プロテーゼは、関節結合の平面部と曲面部とを含むコア部を含み、第１プレートだけが、相補的であるコア部の曲面部の少なくとも一部と協働する関節結合の曲面部を含み、互いに対してプレートを枢動すること及び／又は傾斜することを可能にする。コア部の平面部は、第２プレートの平面部の少なくとも一部と協働し、脊柱の鉛直軸に垂直な少なくとも一方向への第２プレートに対するコア部の移動及び／又は回転を可能にし、第２プレートは、コア部の協働手段と相補的な協働手段を含み、これら協働手段は、第２プレートに対するコア部の少なくともこの移動を制限するか、又は防止し、コア部の関節結合の曲面部の頂部に鉛直方向に整列された関節結合の中心部は、第２プレートの協働手段同士の間のコア部の中央位置、及びコア部に対する第１プレートの曲面部の中心部の中央位置に対応する。 According to another feature, the intervertebral disc prosthesis includes a core portion that includes an articulating planar portion and a curved portion, and only the first plate cooperates with at least a portion of the curved portion of the core portion that is complementary. Includes articulated curved surfaces that allow the plates to pivot and / or tilt relative to each other. The planar portion of the core portion cooperates with at least a portion of the planar portion of the second plate to allow movement and / or rotation of the core portion relative to the second plate in at least one direction perpendicular to the vertical axis of the spinal column; The second plate includes cooperating means complementary to the cooperating means of the core part, the cooperating means limiting or preventing at least this movement of the core part relative to the second plate, The central portion of the joint joint vertically aligned with the top of the curved surface portion of the joint is the central position of the core portion between the cooperating means of the second plate and the central portion of the curved surface portion of the first plate with respect to the core portion. Corresponds to the center position of.
別の特徴によれば、第１プレートの曲面部は凹面であり且つコア部の曲面部は凸面である。 According to another feature, the curved surface portion of the first plate is concave and the curved surface portion of the core portion is convex.
別の特徴によれば、第１プレートの曲面部は凸面であり且つコア部の曲面部は凹面である。 According to another feature, the curved surface portion of the first plate is convex and the curved surface portion of the core portion is concave.
別の特徴によれば、第２プレートの協働手段は、かかる第２プレートのエッジ近傍に配置された雌手段であり、コア部の雄手段と協働する。 According to another characteristic, the cooperating means of the second plate are female means arranged in the vicinity of the edge of the second plate and cooperate with the male means of the core part.
別の特徴によれば、各雄協働手段の寸法は、雌協働手段の寸法よりわずかに小さく、コア部と第２プレートとの間のわずかな移動を関節結合の中心部の鉛直方向投影（ｖｅｒｔｉｃａｌ ｐｒｏｊｅｃｔｉｏｎ）に対応する位置の周りにおいて可能にする。 According to another feature, the dimensions of each male cooperating means are slightly smaller than the dimensions of the female cooperating means, and a slight movement between the core part and the second plate causes a vertical projection of the central part of the articulation. Around the position corresponding to (vertical projection).
別の特徴によれば、各雄協働手段の寸法は、各雌協働手段の寸法と実質的に同一であり、コア部と第２プレートとの間のわずかな移動をも防止し、関節結合の中心部の鉛直方向投影に対応する位置にコア部を保持する。 According to another feature, the dimensions of each male cooperating means are substantially the same as the dimensions of each female cooperating means, preventing even slight movement between the core part and the second plate, The core part is held at a position corresponding to the vertical projection of the central part of the coupling.
別の特徴によれば、第２プレートの協働手段は、第２プレートのエッジ近傍に配置された雄手段であり、コア部の雌手段と協働する。 According to another feature, the cooperating means of the second plate are male means arranged in the vicinity of the edge of the second plate and cooperate with the female means of the core part.
別の特徴によれば、各雄協働手段の寸法は、各雌協働手段の寸法よりわずかに小さく、コア部と第２プレートとの間のわずかな移動を関節結合の中心部の鉛直方向投影に対応する位置の周りにおいて可能にする。 According to another feature, the dimensions of each male cooperating means are slightly smaller than the dimensions of each female cooperating means, and a slight movement between the core part and the second plate is caused in the vertical direction of the central part of the articulation. Allow around the position corresponding to the projection.
別の特徴によれば、各雄協働手段の寸法は各雌協働手段の寸法と実質的に同一であり、コア部と第２プレートとの間のどのような移動をも防止し、関節結合の中心部の鉛直方向投影に対応する位置にコア部を保持する。 According to another feature, the dimensions of each male cooperating means are substantially the same as the dimensions of each female cooperating means, preventing any movement between the core and the second plate, The core part is held at a position corresponding to the vertical projection of the central part of the coupling.
別の特徴によれば、コア部の雄協働手段は、２つのスタッドであり、かかる２つのスタッドはコア部の２つのサイドエッジに配置され、第２プレートの雌協働手段は、４つの壁部であり、かかる４つの壁部はそれぞれ対になり、それぞれ第２プレートの２つのサイドエッジに配置されている。 According to another feature , the male cooperating means of the core part are two studs, the two studs being arranged at the two side edges of the core part, and the female cooperating means of the second plate are four It is a wall part, and these four wall parts are each paired, and are each arrange | positioned at the two side edges of the 2nd plate .
別の特徴によれば、第２プレートの雌協働手段は、プレートの中心に向かう皿状（ｄｉｓｈ ｓｈａｐｅｄ）に形成された部分を含み、コア部の雄協働手段を部分的に被覆し、コア部が持ち上がることを防止する。 According to another feature , the female cooperating means of the second plate includes a dish-shaped portion toward the center of the plate, partially covering the male cooperating means of the core portion, Prevents the core from lifting.
別の特徴によれば、プレートの接触面を示す正中面同士（ｍｅｄｉａｎ ｐｌａｎｅｓ）は、実質的に平行であるか、鋭角を形成し、このような角度により得られた傾斜は、プロテーゼの全体的な形状を脊柱の解剖学的な形状に適合することを可能にするか、又はプロテーゼが挿入される患者の椎骨のどのような傾斜欠陥をも可能な限り矯正することを可能にする。 According to another characteristic , the median planes representing the contact surfaces of the plates are substantially parallel or form an acute angle, and the inclination obtained by such an angle is the overall prosthesis Allows the correct shape to be adapted to the anatomical shape of the spinal column or to correct as much as possible any tilt defects in the vertebrae of the patient into which the prosthesis is inserted.
別の特徴によれば、プレートは、少なくとも下方エッジにおいて、椎骨間へのプロテーゼの挿入を容易にする少なくとも傾斜を含んでいる。 According to another feature , the plate includes at least a slope that facilitates insertion of the prosthesis between the vertebrae, at least at the lower edge.
別の特徴によれば、同一のプレートは、異なる厚さ及び／又は寸法及び／又は形状のコア部と共に組み立てられ得る。 According to another feature, the same plate can be assembled with cores of different thickness and / or size and / or shape.
別の特徴によれば、プレートは可動式骨固着手段を含んでいる。 According to another feature, the plate includes movable bone anchoring means.
別の特徴によれば、骨固着手段及び／又はプレートは、プレートに骨固着手段を拘束する固定手段を含んでいる。 According to another feature, the bone anchoring means and / or the plate includes fixing means for restraining the bone anchoring means to the plate.
別の特徴によれば、プレートの可動式骨固着手段は、ノッチを設けられた少なくとも１つのプレートを含み、かかるノッチは、一旦かかるノッチプレートが椎骨に挿入されると、落下することを防止するように向けられており、かかるプレートの一端は、内側湾曲部を有し、プレートの周囲近傍に配置された開口部の少なくとも１つのエッジに固定される。 According to another feature , the movable bone anchoring means of the plate includes at least one plate provided with a notch that prevents the notch plate from falling once inserted into the vertebra. One end of such a plate has an inner curved portion and is fixed to at least one edge of an opening located near the periphery of the plate.
別の特徴によれば、ノッチプレートの内側湾曲部を伴う端部の反対の端部は、椎骨へのノッチプレートの挿入を容易にする傾斜を有する。 According to another feature , the end opposite the end with the inner curvature of the notch plate has a slope that facilitates insertion of the notch plate into the vertebra.
別の特徴によれば、プレートの周囲近傍に配置された開口部は、傾斜部を含み、骨固着要素の湾曲部がこの開口部のエッジに固定されると、ノッチプレートはかかる傾斜部に寄りかかるので、この傾斜部は、プレートに対する骨固着手段の角度を設定することを可能にし、骨固定手段が開口部に挿入されると、骨固定手段をガイドする。 According to another feature , the opening located near the periphery of the plate includes a ramp, and when the curved portion of the bone anchoring element is secured to the edge of this aperture, the notch plate leans against such ramp. Thus, this inclined part makes it possible to set the angle of the bone anchoring means relative to the plate and guides the bone anchoring means when the bone anchoring means is inserted into the opening.
別の特徴によれば、固定手段は、骨固着手段の湾曲部の方に向けられた可撓性タブからなり、骨固着手段をプレートにおける開口部に挿入すると、かかる可撓性タブは、プレートのエッジに重なり、その後、プレートにおける開口部のエッジへの湾曲部の固定の間、プレートにおける開口部の壁部に配置された制限停止部に寄りかかるようにはね返り（ｓｐｒｉｎｇ ｂａｃｋ）、骨固着手段が落下することを防止する。 According to another feature , the fixing means comprise a flexible tab directed towards the curved portion of the bone anchoring means, such that when the bone anchoring means is inserted into the opening in the plate, the flexible tab is During the fixation of the curved portion to the edge of the opening in the plate and then against the limiting stop located on the wall of the opening in the plate, the bone anchoring means Prevent falling.
別の特徴によれば、可動式骨固着手段のノッチプレートの内側湾曲部は、ノッチを設けられた第２プレートにより伸長し、かかるノッチは、一旦プレートが椎骨に挿入されると、かかるプレートが落下することを防止するように向けられている。 According to another feature , the inner curvature of the notch plate of the movable bone anchoring means is extended by a second plate provided with a notch, such that once the plate is inserted into the vertebrae, the plate It is aimed to prevent falling.
別の特徴によれば、プレートの可動式骨固着手段は、ノッチを設けられた少なくとも１つの翼状部からなり、かかるノッチは、一旦翼状部が椎骨に形成された溝部に挿入されると、翼状部が落下することを防止するように向けられている。翼状部の一端は、内側湾曲部を有し、プレートの周囲近傍における開口部の少なくとも１つのエッジに固定される。 According to another feature , the movable bone anchoring means of the plate consists of at least one wing with a notch, which once is inserted into a groove formed in the vertebrae. Directed to prevent the part from falling. One end of the wing has an inner curved portion and is fixed to at least one edge of the opening in the vicinity of the periphery of the plate.
別の特徴によれば、翼状部の固定手段は、翼状部の下面に配置された少なくとも１つのスタッドからなり、プレートの接触面における少なくとも１つの穴部に固定される。かかるスタッド及び穴部は、プレートの所定位置翼状部を固定するような相補的な形状およびサイズである。 According to another feature , the means for fixing the wings consist of at least one stud arranged on the underside of the wings and are fixed in at least one hole in the contact surface of the plate. Such studs and holes are complementary shape and sized to secure the predetermined position wing of the plate.
本発明の他の特徴及び利点は、添付図面を参照しつつ以下における説明を読むことにより理解されるであろう。 Other features and advantages of the present invention will be understood by reading the following description with reference to the accompanying drawings.
本発明は、脊柱の解剖学的構造に効率的に従うように、互いにオフセットされた少なくとも２つのプレート（１、２）を含んでいる椎間板プロテーゼに関する。本明細書の冒頭において説明したように、椎骨同士は通常互いにわずかにオフセットされており、かかる椎骨のエッジ、例えば後方エッジは鉛直方向に整列されていない。よって、本発明によるプロテーゼは、プレート（１、２）のエッジが、鉛直方向に整列されず且つかかるプロテーゼが挿入される椎骨のエッジ同士の間のオフセットに対応するわずかなオフセットを有するようにデザインされる。椎骨のオフセットは、プレート（１、２）のオフセットがかかる椎骨のオフセットに完全に一致するプロテーゼを選択するために、事前に正確に測定され得る。 The present invention relates to an intervertebral disc prosthesis comprising at least two plates (1, 2) that are offset from each other so as to efficiently follow the anatomy of the spinal column. As explained at the beginning of the specification, the vertebrae are usually slightly offset from each other, and the edges of such vertebrae, for example the posterior edges, are not vertically aligned. Thus, the prosthesis according to the present invention is designed so that the edges of the plates (1, 2) are not vertically aligned and have a slight offset corresponding to the offset between the edges of the vertebrae into which such prosthesis is inserted. Is done. Vertebral offset can be accurately measured in advance to select a prosthesis where the offset of the plates (1, 2) exactly matches the offset of such vertebrae.
本発明によるプロテーゼのプレート（１及び２）は、一般的に、かかるプレート（１、２）の周囲に配置された２つの対向する点から等距離の点により画定され得る幾何学的中心部（Ｇ１及びＧ２）を含んでいる。通常、椎間板プロテーゼのプレートは、比較的単純な（ｓｔｒａｉｇｈｔｆｏｒｗａｒｄ）形状を有し、かかるプレートの幾何学的中心部は、かかるプレートの周囲に配置された全ての点から等距離であり得る。プロテーゼにかかわらず、幾何学的中心部はプレートのエッジから等距離に配置された点又は面により画定され得る。本発明によるプロテーゼのプレート（１、２）の幾何学的中心部（Ｇ１、Ｇ２）は、鉛直方向に整列されておらず、少なくとも一方向、例えば脊柱の鉛直軸に垂直な前方−後方へ互いにオフセットされている。１つの椎間板プロテーゼの２つのプレート（１及び２）は、通常、実質的に同一のサイズであり、かかるプレートの幾何学的中心部（Ｇ１、Ｇ２）のこのオフセット（Ｄ）は、かかるプレート（１、２）のエッジのオフセットを生ずる。プレートが同じサイズでないプロテーゼの場合においては、プレート（１及び２）のエッジをオフセットすることが予想され、幾何学的中心部（Ｇ１、Ｇ２）は互いに、よりオフセットされる。 A plate (1 and 2) of a prosthesis according to the present invention generally has a geometrical center (which can be defined by a point equidistant from two opposing points arranged around such a plate (1,2). G1 and G2). Typically, the plates of the intervertebral disc prosthesis have a relatively straight shape, and the geometric center of such a plate can be equidistant from all points located around the plate. Regardless of the prosthesis, the geometric center can be defined by a point or plane located equidistant from the edge of the plate. The geometric centers (G1, G2) of the plates (1, 2) of the prosthesis according to the invention are not aligned in the vertical direction and are mutually in an anterior-posterior direction at least in one direction, eg perpendicular to the vertical axis of the spinal column. It is offset. The two plates (1 and 2) of a disc prosthesis are usually of substantially the same size, and this offset (D) of the geometric center (G1, G2) of such plates is 1, 2) edge offset is generated. In the case of prostheses where the plates are not the same size, it is expected to offset the edges of the plates (1 and 2) and the geometric centers (G1, G2) are more offset from each other.
以下において説明される異なる実施例においては、プロテーゼは、少なくとも２つのプレート（１及び２）、すなわち第１プレート（１）と第２プレート（２）とを含み、かかるプレートは、少なくとも一方のプレートの曲面部（１１、３１）、すなわち関節結合により互いに関節結合されている。関節結合のこの曲面部（１１、３１）は、プレートの平面に実質的に垂直な軸の周りの回転を介して、プレート（１、２）を互いに枢動すること、及び／又はプレート（１，２）の平面に実質的に沿った軸の周りの回転を介して、プレート（１、２）を互いに傾斜することを可能にする。各プレート（１，２）は、接触面として公知な表面（１４、２４）を含み、かかる表面（１４、２４）は、プロテーゼが挿入される椎骨間の１つの椎骨プレートと接触する。幾何学的中心部は、これ以降、簡易性のためにこの接触面に関して画定されるが、本発明の原理において重要であることは、幾何学的中心部を貫通する鉛直軸であり、プレートの幅における幾何学的中心部の正確な位置は直接関係ないことを理解されたい。以下において説明される異なる実施例においては、各プレート（１、２）は、プレート（１、２）の周囲に配置された少なくとも２つの直径方向に対向する点から等距離の幾何学的中心部（Ｇ１、Ｇ２）を含んでいる。プレート（１、２）の幾何学的中心部（Ｇ１、Ｇ２）は鉛直方向に整列されておらず、プレートの幾何学的中心部（Ｇ１、Ｇ２）のこのオフセット（Ｄ）は、脊柱の鉛直軸に垂直な少なくとも１つの方向へのプレート（１、２）のエッジのオフセットを生ずる。 In the different embodiments described below, the prosthesis comprises at least two plates (1 and 2), namely a first plate (1) and a second plate (2), which plate is at least one plate. The curved surface portions (11, 31), ie, articulated with each other by articulation. This curved portion (11, 31) of the articulation pivots the plates (1, 2) relative to each other and / or the plate (1) via rotation about an axis substantially perpendicular to the plane of the plate. , 2), allowing rotation of the plates (1, 2) relative to each other via rotation about an axis substantially along the plane of. Each plate (1, 2) includes a surface (14, 24) known as a contact surface, such surface (14, 24) making contact with one vertebra plate between the vertebrae into which the prosthesis is inserted. The geometric center is hereafter defined with respect to this contact surface for simplicity, but what is important in the principles of the present invention is the vertical axis through the geometric center and the plate It should be understood that the exact location of the geometric center in the width is not directly related. In the different embodiments described below, each plate (1, 2) is a geometric center equidistant from at least two diametrically opposed points arranged around the plate (1, 2). (G1, G2) are included. The geometric centers (G1, G2) of the plates (1, 2) are not vertically aligned and this offset (D) of the geometric centers (G1, G2) of the plates is the vertical of the spine An offset of the edge of the plate (1,2) in at least one direction perpendicular to the axis is produced.
図２Ａ、図２Ｂ、図２Ｃ、図３Ｃ、及び図３Ｄに示した実施例においては、プロテーゼは、２つの要素、すなわち２つのプレート（１、２）を含んでいるだけである。この場合においては、第２プレート（２）が関節結合の曲面部（３１）を含み、かかる曲面部（３１）の少なくとも一部が、相補関係である第１プレート（１）の関節結合の曲面部（１１）と協働する。関節結合のこれらの曲面部（１１、３１）の協働は、互いに対してプレート（１、２）を枢動すること及び／又は傾斜することを可能にする。第２プレート（２）の関節結合の曲面部（３１）の頂部と鉛直方向に整列された関節結合の中心部（Ｃ）が画定され得る。関節結合のかかる中心部（Ｃ）は、第２プレート（２）と比較して、第１プレート（１）の曲面部（１１）の中心部の中央位置に相当する。図面に示した実施例においては、第１プレート（１）の曲面部（１１）は凹面であり且つ第２プレート（２）の関節結合の曲面部（３１）は凸面であるが、第１プレート（１）の曲面部（１１）が凸面であり且つ第２プレート（２）の関節結合の曲面部（３１）が凹面である場合もあり得る。 In the embodiment shown in FIGS. 2A, 2B, 2C, 3C and 3D, the prosthesis only includes two elements, namely two plates (1, 2). In this case, the second plate (2) includes a curved surface portion (31) for joint connection, and at least a part of the curved surface portion (31) is a curved surface for joint connection of the first plate (1) in a complementary relationship. Work with the department (11). The cooperation of these curved parts (11, 31) of the articulation makes it possible to pivot and / or tilt the plates (1, 2) relative to each other. An articulation center (C) aligned vertically with the top of the articulation curved surface (31) of the second plate (2) may be defined. The central part (C) to which the joint is applied corresponds to the central position of the central part of the curved surface part (11) of the first plate (1) as compared with the second plate (2). In the embodiment shown in the drawing, the curved surface portion (11) of the first plate (1) is concave and the curved surface portion (31) of the joint connection of the second plate (2) is convex, but the first plate There may be a case where the curved surface portion (11) of (1) is a convex surface and the curved surface portion (31) of the joint connection of the second plate (2) is a concave surface.
図１Ａ乃至図１Ｃ、図３Ａ、図３Ｂ、及び図５Ａ乃至図５Ｃに示した実施例においては、プロテーゼは、関節結合の平面部（３３）と曲面部（３１）とを含むコア部（３）を含んでいる。３つの要素を伴うプロテーゼの場合においては、第１プレートだけが関節結合の曲面部（１１）を含み、かかる曲面部が、相補的であるコア部（３）の曲面部（３１）の少なくとも一部と協働し、互いにプレート（１、２）を枢動及び／又は傾斜することを可能にする。コア部（３）の平面部（３３）は、第２プレート（２）の平面部（２３）の少なくとも一部と協働し、第２プレート（２）に対するコア部（３）の脊柱の鉛直軸に垂直な少なくとも一方向への移動及び／又はかかる平面部の面に実質的に垂直な軸の周りの回転を介して、第２プレート（２）に対するコア部（３）の回転を可能にする。第２プレート（２）は、コア部（３）の協働手段（３２）と相補的である協働手段（２２）を含み、第２プレート（２）に対するコア部（３）の少なくともこの移動を制限するか、又は防止する。図面に示した実施例においては、第２プレート（２）の協働手段（２２）は、第２プレート（２）のエッジ近傍に配置された雌手段であり、コア部（３）の雄手段と協働する。図面に示した実施例においては、コア部のこれらの雄協働手段（３２）は２つのスタッドであり、かかる２つのスタッドは、かかるコア部（３）の２つのサイドエッジに配置され、第２プレート（２）の雌協働手段（２２）は、４つの壁部であり、かかる４つの壁部は、対になり、第２プレート（２）の２つのサイドエッジにそれぞれ配置されている。これらの壁部は、プレートの中心に向かう内側湾曲部を含み、コア部（３）の雄協働手段（３２）を部分的に被覆し、コア部（３）が持ち上がることを防止する。本発明の別の実施例においては、第２プレート（２）の協働手段（２２）は、第２プレート（２）のエッジ近傍に配置された雄手段であり、コア部（３）の雌手段（３２）と協働する。本発明の実施例においては、各雄協働手段（３２、２２）の寸法は、雌協働手段（２２、３２）の寸法よりわずかに小さく、コア部（３）と第２プレート（２）との間のわずかな移動を関節結合の中心部（Ｃ）の鉛直方向投影に対応する位置の周りにおいて可能にする。別の実施例においては、各雄協働手段（３２、２２）の寸法は、各雌協働手段（２２、３２）の寸法と実質的に同一であり、コア部（３）と第２プレート（２）との間のどのような移動をも防止し、関節結合の中心部（Ｃ）の鉛直方向投影に対応する位置にコア部（３）を保持する。 In the embodiments shown in FIGS. 1A to 1C, 3A, 3B, and 5A to 5C, the prosthesis includes a core portion (3) including a joint-joining flat surface portion (33) and a curved surface portion (31). ) Is included. In the case of a prosthesis with three elements, only the first plate includes an articulated curved surface portion (11), which is at least one of the curved surface portion (31) of the complementary core portion (3). Cooperating with the part makes it possible to pivot and / or tilt the plates (1, 2) relative to each other. The flat surface portion (33) of the core portion (3) cooperates with at least a part of the flat surface portion (23) of the second plate (2) and is perpendicular to the spine of the core portion (3) with respect to the second plate (2). Allows rotation of the core part (3) relative to the second plate (2) via movement in at least one direction perpendicular to the axis and / or rotation about an axis substantially perpendicular to the plane of such a plane part To do. The second plate (2) comprises cooperating means (22) complementary to the cooperating means (32) of the core part (3), at least this movement of the core part (3) relative to the second plate (2). Restrict or prevent In the embodiment shown in the drawing, the cooperating means (22) of the second plate (2) is female means arranged in the vicinity of the edge of the second plate (2), and the male means of the core part (3). Collaborate with. In the embodiment shown in the drawing, these male cooperating means (32) of the core part are two studs, which are arranged at the two side edges of such core part (3), The female cooperating means (22) of the two plates (2) is four wall portions, and the four wall portions are paired and arranged on the two side edges of the second plate (2), respectively. . These wall parts include an inner curved part toward the center of the plate, partially covering the male cooperating means (32) of the core part (3) and preventing the core part (3) from lifting. In another embodiment of the present invention, the cooperating means (22) of the second plate (2) is a male means arranged in the vicinity of the edge of the second plate (2), and the female of the core part (3). Cooperating with means (32). In the embodiment of the present invention, the dimension of each male cooperating means (32, 22) is slightly smaller than the dimension of the female cooperating means (22, 32), and the core (3) and the second plate (2). Is allowed around the position corresponding to the vertical projection of the articulation center (C). In another embodiment, the dimensions of each male cooperating means (32, 22) are substantially the same as the dimensions of each female cooperating means (22, 32), and the core (3) and the second plate. Any movement with respect to (2) is prevented, and the core (3) is held at a position corresponding to the vertical projection of the central part (C) of the joint connection.
３つの要素を伴うプロテーゼのこの場合においては、関節結合の中心部（Ｃ）は、コア部（３）の関節結合の曲面部（３１）の頂部と鉛直方向に整列され、第２プレート（２）の協働手段（２２）同士の間のコア部（３）の中央位置及びコア部（３）に対する第１プレート（１）の曲面部（１１）の中心部の中央位置に対応する。図面に示した実施例においては、第１プレート（１）の曲面部（１１）は凹面であり且つコア部（３）の曲面部（３１）は凸面であるが、第１プレート（１）の曲面部（１１）は凸面であり且つコア部（３）の曲面部（３１）は凹面であり得る。 In this case of a prosthesis with three elements, the articulation center (C) is vertically aligned with the top of the articulation curved surface (31) of the core (3) and the second plate (2 ) Corresponding to the central position of the core part (3) between the cooperating means (22) and the central position of the central part of the curved surface part (11) of the first plate (1) with respect to the core part (3). In the embodiment shown in the drawings, the curved surface portion (11) of the first plate (1) is concave and the curved surface portion (31) of the core portion (3) is convex, but the first plate (1) The curved surface portion (11) may be convex and the curved surface portion (31) of the core portion (3) may be concave.
本発明の実施例においては、関節結合の中心部（Ｃ）は、第１プレート（１）の幾何学的中心部（Ｇ１）に鉛直方向に整列されているが、少なくとも脊柱の鉛直軸に垂直な方向へ、第２プレート（２）の幾何学的中心部（Ｇ２）に対してオフセットされている。プレートの幾何学的中心部（Ｇ１、Ｇ２）のオフセット（Ｄ）は、脊柱の鉛直軸に垂直な少なくとも一方向へのプレート（１、２）のエッジのオフセットを生ずる。本発明の別の実施例においては、関節結合の中心部（Ｃ）は、第１プレート（１）の幾何学的中心部（Ｇ１）に対してオフセットされ得る。第１プレート（１）の幾何学的中心部（Ｇ１）に対する関節結合の中心部のこのオフセットは、第２プレート（２）の幾何学的中心部（Ｇ２）に対する関節結合の中心部（C）のオフセット（Ｄ）の向きと反対であり、関節結合の中心部（Ｃ）の鉛直方向投影は、プレート（１、２）の幾何学的中心部（Ｇ１、Ｇ２）の鉛直方向投影同士の間に存在し、関節結合の中心部（Ｃ）に対する幾何学的中心部（Ｇ１、Ｇ２）のオフセットが、重なり、脊柱の鉛直軸に垂直な少なくとも一方向への、プレート（１，２）のエッジのオフセットを生ずる。第１プレート（１）の幾何学的中心部（Ｇ１）に対する関節結合の中心部（Ｃ）のオフセットは、第２プレート（２）の幾何学的中心部（Ｇ２）に対する関節結合の中心部（C）のオフセット（Ｄ）と同一の方向であってもよいが、より小さな距離であり、これらのオフセットは、互いを部分的に補償し、脊柱の鉛直軸に垂直な少なくとも一方向への、プレート同士の間にプレート（１、２）のエッジのオフセットを生ずる。 In an embodiment of the invention, the articulation center (C) is vertically aligned with the geometric center (G1) of the first plate (1) but at least perpendicular to the vertical axis of the spinal column. Is offset with respect to the geometric center (G2) of the second plate (2). The offset (D) of the geometric center (G1, G2) of the plate results in an offset of the edge of the plate (1, 2) in at least one direction perpendicular to the vertical axis of the spinal column. In another embodiment of the invention, the articulation center (C) may be offset with respect to the geometric center (G1) of the first plate (1). This offset of the center of articulation relative to the geometric center (G1) of the first plate (1) is the center of articulation (C) relative to the geometric center (G2) of the second plate (2). of a direction opposite to the offset (D), the vertical projection of the center of articulation (C) during the vertical projection between the plates geometric center of (1,2) (G1, G2) The edge of the plate (1, 2) in at least one direction perpendicular to the vertical axis of the spinal column, with the offset of the geometric center (G1, G2) relative to the articulation center (C) Produces an offset of The offset of the joint center (C) with respect to the geometric center (G1) of the first plate (1) is the center of the joint (G2) with respect to the geometric center (G2) of the second plate (2). C) may be in the same direction as the offset (D), but at a smaller distance, these offsets partially compensate for each other and in at least one direction perpendicular to the vertical axis of the spinal column, There is an offset of the edges of the plates (1, 2) between the plates.
本発明によるプロテーゼが、かかるプロテーゼが挿入される椎骨の傾斜欠陥を良くすることは有益である。プレート（１、２）の接触面（１４、２４）を示す正中面（ｍｅｄｉａｎ ｐｌａｎｅｓ）同士は、実質的に平行であるか、又は鋭角を形成する。このような角度により得られる傾斜は、プロテーゼの全体的な形状を脊柱の解剖学的形状に適合することを可能にするか、又はプロテーゼが移植される患者の椎骨の起こり得る傾斜欠陥を修正することを可能にする。同一のプレート（１、２）は、異なる厚み及び／又は寸法及び／又は形状のコア部（３）と共に組み立てられ得る。プレート（１、２）は、少なくともかかるプレート（１、２）の前方エッジにおいて、椎骨間へのプロテーゼの挿入を容易にする少なくとも１つの傾斜部（１２）を含み得る。 It would be beneficial for a prosthesis according to the present invention to improve tilt defects in the vertebrae into which such prostheses are inserted. The median planes representing the contact surfaces (14, 24) of the plates (1, 2) are substantially parallel or form an acute angle. The inclination obtained by such an angle allows the overall shape of the prosthesis to be adapted to the anatomy of the spinal column or corrects possible inclination defects in the vertebrae of the patient into which the prosthesis is implanted. Make it possible. The same plate (1, 2) can be assembled with cores (3) of different thickness and / or size and / or shape. The plates (1, 2) may include at least one ramp (12) that facilitates insertion of the prosthesis between the vertebrae, at least at the anterior edge of such plates (1, 2).
本発明の実施例によるプロテーゼは、椎骨にプレート（１、２）を固着することを可能にする取り外し自在な（すなわち可動式の）骨固着手段（４Ａ、４Ｂ）を含んでいる。これらの骨固着手段（４Ａ、４Ｂ）及び／又はプレート（１、２）は、骨固着手段（４Ａ、４Ｂ）をプレート（１、２）に拘束する固定手段（４３及び／又は２１１、２１２）を含んでいる。 The prosthesis according to an embodiment of the present invention includes removable (ie, movable) bone anchoring means (4A, 4B) that allow the plates (1, 2) to be anchored to the vertebrae. These bone anchoring means (4A, 4B) and / or plates (1, 2) are fixed means (43 and / or 211, 212) for restraining the bone anchoring means (4A, 4B) to the plates (1, 2). Is included.
可動式骨固着手段（４Ｂ）の第１実施例においては、ノッチ（４２）を設けられた少なくとも１つのプレート（４０）が、内側湾曲部（４１）により、プレート（１、２）の周囲近傍における開口部の少なくとも１つのエッジ（２１）に固定される。かかるノッチ（４２）は、一旦かかるプレート（４０）が椎骨に挿入されると、このノッチプレート（４０）が落下することを防止するように向けられている。よって、これらの可動式骨固着手段（４Ｂ）は、脊柱に挿入され、一旦後部が椎骨同士の間に挿入されるとプロテーゼのプレートに固定される。可動式骨固着手段（４Ｂ）のこの実施例は、最終的な固定の前に、椎骨同士の間のプロテーゼの位置の調整を可能にする。ノッチプレート（４０）の内側湾曲部（４１）を伴う端部の反対の端部は、椎骨へのかかるノッチプレート（４０）の挿入を容易にする傾斜を含んでいる。プレート（１、２）の周囲近傍における開口部は傾斜部（２１０）を含み、骨固着手段（４Ｂ）の湾曲部（４１）がこの開口部のエッジ（２１）に固定されると、ノッチプレート（４０）はかかる傾斜部（２１０）に寄りかかる。この傾斜部（２１０）は、プレートに対する骨固着手段（４Ｂ）の角度を設定することを可能にし、かかる骨固着手段（４Ｂ）が開口部に挿入されると、かかる骨固着手段（４Ｂ）をガイドする。固定手段（４３）は、骨固着手段（４Ｂ）の湾曲部（４１）の方に向けられた可撓性タブ（４３）からなり、プレート（１、２）における開口部へ骨固着手段（４Ｂ）を挿入すると、プレート（４０）のエッジに対して折り重なる。プレート（１、２）における開口部のエッジへの湾曲部（４１）の固定の間、これらの可撓性タブ（４３）は、プレート（１、２）における開口部の壁部に配置された制限停止部（２１１）に寄りかかるように分かれ、骨固着手段（４Ｂ）が落下することを防止する。別の実施例においては、可動式骨固着手段（４）のノッチプレート（４０）の内側湾曲部（４１）は、一旦プレート（４０）が椎骨に挿入されると、プレート（４０）が落ちることを防止するように向けられたノッチ（４２）を設けられた第２プレート（４０）を介して伸長する。 In the first embodiment of the movable bone anchoring means (4B), at least one plate (40) provided with a notch (42) is provided in the vicinity of the periphery of the plates (1, 2) by the inner curved portion (41). Is fixed to at least one edge (21) of the opening. The notch (42) is oriented to prevent the notch plate (40) from falling once such plate (40) is inserted into the vertebra. Thus, these movable bone anchoring means (4B) are inserted into the spinal column and once the posterior part is inserted between the vertebrae, they are secured to the prosthesis plate. This embodiment of the mobile bone anchoring means (4B) allows adjustment of the position of the prosthesis between the vertebrae before final fixation. The opposite end of the notch plate (40) with the inner curve (41) includes a bevel that facilitates insertion of such a notch plate (40) into the vertebra. The opening in the vicinity of the periphery of the plates (1, 2) includes an inclined portion (210), and when the curved portion (41) of the bone fixing means (4B) is fixed to the edge (21) of this opening, a notch plate (40) leans on the inclined part (210). This inclined part (210) makes it possible to set the angle of the bone anchoring means (4B) with respect to the plate, and when the bone anchoring means (4B) is inserted into the opening, the bone anchoring means (4B) To guide. The fixing means (43) consists of a flexible tab (43) directed towards the curved portion (41) of the bone anchoring means (4B), and the bone anchoring means (4B) to the openings in the plates (1, 2). ) Is folded over the edge of the plate (40). During the fastening of the curved part (41) to the edge of the opening in the plate (1,2), these flexible tabs (43) were placed on the wall of the opening in the plate (1,2). It is divided so as to lean on the limit stop part (211), and the bone fixing means (4B) is prevented from falling. In another embodiment, the inner curvature (41) of the notch plate (40) of the movable bone anchoring means (4) may cause the plate (40) to fall once the plate (40) is inserted into the vertebra. Elongate through a second plate (40) provided with a notch (42) directed to prevent.
プレート（１、２）の可動式骨固着手段（４Ａ、４Ｂ）の第２実施例においては、少なくとも１つの翼状部（４Ａ）にはノッチ（４２）が設けられ、かかるノッチ（４２）は、一旦翼状部（４Ａ）が椎骨に形成された溝へ挿入されると、翼状部（４Ａ）が落下することを防止するように向けられている。翼状部（４Ａ）の一端は、内側湾曲部（４１）を有し、プレート（１、２）の周囲近傍における開口部の少なくとも１つのエッジ（２１）に固定される。翼状部（４Ａ）の固定手段（４３）は、少なくとも翼状部（４Ａ）の下面に配置されたスタッド（４３）からなり、プレート（１、２）の接触面（１４、２４）における少なくとも１つの穴部（２１０）に固定される。スタッド（４３）及び穴部（２１０）は、翼状部（４Ａ）をプレート（１、２）に固定するような相補的な形状およびサイズである。この実施例においては、プロテーゼが挿入される椎骨は、椎骨プレートにおいて、翼状部（４Ａ）の形状及びサイズと相補的な形状及びサイズの溝をくり抜く（ｈｏｌｌｏｗｉｎｇ ｏｕｔ）ことにより外科医により前もって処置されている。 In a second embodiment of the movable bone anchoring means (4A, 4B) of the plates (1, 2), at least one wing (4A) is provided with a notch (42), Once the wing (4A) is inserted into a groove formed in the vertebra, it is oriented to prevent the wing (4A) from falling. One end of the wing portion (4A) has an inner curved portion (41) and is fixed to at least one edge (21) of the opening in the vicinity of the periphery of the plates (1, 2). The fixing means (43) of the airfoil (4A) comprises at least a stud (43) disposed on the lower surface of the airfoil (4A), and at least one of the contact surfaces (14, 24) of the plates (1, 2). It is fixed to the hole (210). Stud (43) and the hole (210) is a complementary shape and sized to fixed wing-shaped part (4A) to the plate (1, 2). In this embodiment, the vertebrae into which the prosthesis is inserted have been previously treated by the surgeon by hollowing out a shape and size groove in the vertebra plate that is complementary to the shape and size of the wing (4A). Yes.
本発明は特許請求の範囲に記載されたような本発明の範囲を残しつつ、多数の他の特定の形態の実施例が可能であることは当業者には明らかである。よって、実施例は、単なる例示目的として考慮されるべきであり、従属請求項の影響により画定される範囲において変更され、本発明は前述した記述に制限されるべきではない。 It will be apparent to those skilled in the art that the invention is capable of many other specific forms of embodiments, while remaining within the scope of the invention as set forth in the claims. Accordingly, the embodiments are to be considered merely for illustrative purposes and are modified within the scope defined by the influence of the dependent claims, and the invention should not be limited to the foregoing description.
Applications Claiming Priority (3)
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| FR0509740A FR2891135B1 (en) | 2005-09-23 | 2005-09-23 | INTERVERTEBRAL DISC PROSTHESIS |
| PCT/IB2006/002632 WO2007034310A1 (en) | 2005-09-23 | 2006-09-23 | Intervertebral disc prosthesis |
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| JP2009508615A5 true JP2009508615A5 (en) | 2011-07-28 |
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| JP2008531811A Expired - Fee Related JP4814942B2 (en) | 2005-09-23 | 2006-09-23 | Intervertebral disc prosthesis |
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- 2006-09-23 CA CA2622028A patent/CA2622028C/en not_active Expired - Fee Related
- 2006-09-23 AT AT06808881T patent/ATE537786T1/en active
- 2006-09-23 KR KR1020087009750A patent/KR101333755B1/en not_active IP Right Cessation
- 2006-09-23 PT PT06808881T patent/PT1968500E/en unknown
-
2010
- 2010-11-29 US US12/955,898 patent/US8979932B2/en active Active
-
2015
- 2015-03-16 US US14/659,587 patent/US9597194B2/en active Active
-
2017
- 2017-03-21 US US15/464,639 patent/US10492919B2/en active Active
-
2019
- 2019-11-27 US US16/698,485 patent/US11872138B2/en active Active
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